Impact of the COVID-19 pandemic on time to diagnosis and treatment in children with cancer at tertiary care level.

Abstract

The UK NHS responded to the COVID-19 pandemic from early 2020 by focusing all, bar indispensable services, on pandemic management. There are numerous reports of the adverse impact this diversion of resources has had on various health services, including cancer care. The degree to which childhood cancer services have been affected, including diagnostic delay, are less well documented. Such delays have been observed at presentation to primary and secondary care [1,2]. Further delays may occur at any stage of a child’s diagnostic journey, including assessment and investigation by primary or secondary care; and delays to diagnostic work-up at tertiary level. The latter would seem to be particularly susceptible to the diversion of resources, as the initial management of children with cancer relies on the very services required for acute pandemic management, including access to e.g., anaesthetics, theatres, and surgery. Here, we assessed the impact of the COVID-19 pandemic on the initial management of children with cancer who presented to our regional tertiary service by auditing (against nationally defined standards [3,4]) the time to achieving key milestones.